Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03865 | Date 26/02/2019 |
| Token No | SM/18-19/9449 26/02/2019 | Serial | 002 Last Visit: 26/02/2019 |
| Patient Name | Mrs. ANUSHRI GHOSH | Contact No | 8478874927 |
| Address | 10 A/2 CHATRA GHOSH PARA,1ST.LANE, | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||